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In modern psychology, the term neurosis, also known as psychoneurosis or neurotic disorder, is a general term that refers to any mental imbalance that causes distress, but does not interfere with rational thought or an individual's ability to function in daily life. As an illness, it represents a psychiatric condition in which emotional distress or unconscious conflict is expressed through various physical, physiological, and mental disturbances (as physical symptoms, anxieties, or phobias). It has perhaps been most simply defined as a "poor ability to adapt to one's environment, an inability to change one's life patterns, and the inability to develop a richer, more complex, more satisfying personality." (Boeree 2002) Neurosis should not be mistaken for psychosis, which refers to more severe disorders.
The term connotes an actual disorder or disease, but under its general definition, neurosis is a normal human experience, part of the human condition. Most people are affected by neurosis in some form. A psychological problem develops when neuroses begin to interfere with, but not significantly impair, normal fuctioning, and thus cause the individual anxiety. Frequently, the coping mechanisms enlisted to help "ward off" the anxiety only exacerbate the situation, causing more distress. It has even been defined in terms of this coping strategy, as a "symbolic behavior in defense against excessive psychobiologic pain...," which, "...is self-perpetuating because symbolic satisfactions cannot fulfill real needs." (Janov 1998)
Some neuroses may be rooted in ego defense mechanisms, but the two concepts are not synonymous. Defense mechanisms are a normal way of developing and maintaining a consistent sense of self (an ego) while only those thought and behavior patterns that produce difficulties in living should be termed neuroses.
A neurosis, in psychoanalytic theory, is an ineffectual coping strategy that Sigmund Freud suggested is a situation where the ego's efforts to resolve emotional conflicts between the Id and Superego using one or more coping or defense mechanisms fail. As Freud himself states in his Introductory Lectures, a person "only falls ill of a neurosis if his ego has lost the capacity to allocate his libido in some way." Similarly, in Carl Jung's theory of analytical psychology, a neurosis results from the conflict of two psychic contents, one of which must be unconscious.
Effects and symptoms
There are many different specific forms of neuroses: pyromania, obsessive-compulsive disorder, anxiety neurosis, hysteria (in which anxiety may be discharged through a physical symptom), and an endless variety of phobias. According to Dr. George Boeree, effects of neuosis can involve
... anxiety, sadness or depression, anger, irritability, mental confusion, low sense of self-worth, etc., behavioral symptoms such as phobic avoidance, vigilance, impulsive and compulsive acts, lethargy, etc., cognitive problems such as unpleasant or disturbing thoughts, repetition of thoughts and obsession, habitual fantasizing, negativity and cynicism, etc. Interpersonally, neurosis involves dependency, aggressiveness, perfectionism, schizoid isolation, socio-culturally inappropriate behaviors, etc. (Boeree 2002)
Although neuroses are targeted by psychoanalysis, psychotherapy/counselling, or other psychiatric techniques, there is still controversy over whether even these professionals can perform accurate and reliable diagnoses, and whether many of the resulting treatments are also appropriate, effective and reliable. Some studies show no extra benefit gained from talk therapies when compared with other kinds of (untrained) personal companionship and discussion.
While the traditional talk-therapies (e.g. psychoanalysis) encourage the patient to explore these thought patterns, an argument can be made that cognitive therapy (which offers patients specific guidance on reshaping and replacing old patterns with new, more functional ones) should be more effective. However, since cognitive therapies rely on logical and reasonable communication and thought patterns, it may be that many patients are not sufficiently advanced in intelligence and self-control to benefit from the techniques. More research is needed about the relationship between different types of intelligence, personality, and the patient's responsiveness to different treatment techniques.
History and use of the term
The term was coined by the Scottish doctor William Cullen in 1769 to refer to "disorders of sense and motion" caused by a "general affection of the nervous system." For him, it described various nervous disorders and symptoms that could not be explained physiologically. It derives from two Greek words: neuron (nerve) and osis (diseased or abnormal condition).
Throughout its history, the term "neurosis", while adhering generally to the above definitions, has been used as a catch-all term for many medical or psychological phenomena. Partly due to this lack of definition, it is clinically no longer in common use. Current classification systems have abandoned the category of neurosis; the DSM-IV has eliminated the category altogether. Disorders formerly termed as neuroses are now described under more specific disorders such as anxiety, depression, and personality disorders. Still, the usage of the term neurosis remains controversial, and it has been argued that a more appropriate term is needed to replace it.
- Freud, Sigmund. The Standard Edition of the Complete Psychological Works of Sigmund Freud. Trans. James Strachey. 24 vols. London: Hogarth, 1953-74.
- Boeree, Dr. C. George. "A Bio-Social Theory of Neurosis", Copyright 2002.
- Horney, Karen. The Collected Works. (2 Vols.) Norton, 1937.
- Janov, Dr. Arthur. "Neurosis", Copyright 1998.
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